Massey PB. Altern Ther Health Med. 2007 May-Jun;13(3):32-4.
Complementary and Alternative Medicine at Alexian Brothers Hospital Network, Elk Grove Village, Ill, USA.
OBJECTIVE: To evaluate the effectiveness of a modified Myers' formula of intravenous nutrient therapy (IVNT) on the symptoms of fibromyalgia (FM) in therapy-resistant FM patients. Methods: In this pilot clinical trial, 7 participants with therapy resistant FM were given IVNT once per week for 8 weeks. Patient's pain levels, fatigue, and activities of daily living were evaluated weekly. RESULTS: All participants reported decreased pain levels, decreased fatigue, and increased activities of daily living. Participants noted increased energy levels within 24-48 hours of the initial infusion. At the end of the study, all participants reported increased energy and activities of daily living as well as a 60% reduction in pain (P=.005) and an 80% decrease in fatigue (P=-.005). No participants, however, reported complete or lasting resolution of pain or fatigue. No side effects were reported. DISCUSSION: Anecdotal reports have indicated benefit for IVNT for patients with chronic pain, including FM. However, except for 2 reports, the medical literature is devoid of any studies of IVNT for the treatment of FM. In this pilot study, 7 participants received IVNT once a week for 8 weeks. All participants had long-standing FM (at least 8 years) and had tried conventional therapies, such as antidepressants, nonsteroidal anti-inflammatory drugs, and exercise, without significant or lasting relief. All had improvement in symptoms and increases in their activities of daily living, although no participant reported complete resolution of symptoms. IVNT appears to be safe to reduce FM symptoms.
PMID: 17515022 [PubMed - indexed for MEDLINE]
Myers Cocktail (Used with permission - From Fatigued to Fantastic! Penguin/Avery Oct 2007)
The following are instructions for your physician for making up and administering the slow IV Myers Push (MP).
Supplies Needed / Amount Needed
1. Bacteriostatic water / 7 cc
2. Ascorbic acid (500 mg/ml), preservative-free / 1-10 cc (I often give 20-40 cc Vitamin C over 30-40 minutes)
3. Magnesium sulfate (MgSO4), 50 percent (0.5 mg/ml) / 2-4 cc
4. Pyridoxine (100 mg/ml), preservative-free / 1 cc
5. Hydroxycobalamin (3,000 mcg/ml) / 1 cc (give IM)
6. B-Complex 100 / 0.5-1 cc
7. Dexpanthenol (250 mg/ml) / 0.5 cc
8. Glutathione, 200 mg per cc (optional) / 2-5 cc (Push in separately-do not mix in the same syringe with other nutrients.)
9. 20-cc or 25-cc syringes
10. 18 gauge, 1 to 1H-inch needles
11. 25 gauge, I-inch butterfly sets
12. Calcium gluconate, 10 percent, preservative-free (optional) / 4-10 cc
Items 1 through 3 and 6 through 12 can be ordered (among other sources) from Harvard Drug Company. (800-783-7103). Item 4 can be obtained from compounding pharmacies, including Pathways and Wellness and Health Pharmaceuticals. Item 5 can be purchased from G.Y. and N. Most of the above items are also available from McGuff.
To make the Myers Push (MP), draw up each ingredient using a separate syringe/needle and squirt it into the mouth of a 20-cc to 25-cc syringe. Attach the 25-gauge butterfly to the large syringe, pushing fluid through the butterfly tubing until the entire tubing and needle are filled. Now the mixture is ready for venipuncture and a slow IV push. The glutathione should be kept in the initial syringe (not mixed with other nutrients) and pushed in over one to ten minutes (1 cc every one to two minutes).
The dose of MgSO4 typically begins at 2 cc. If the patient feels comfortable, without dizziness, nausea, or hypotension (warmth in the neck, face, chest, abdomen, groin, and/or extremities is normal, and is a sign of physiological action of the magnesium as a vasodilator), I usually increase the MgSO4 to 4 cc and give it over ten to forty minutes. Alternately, all these nutrients can be added in an IV bag and allowed to drip in over thirty to sixty minutes.
The desired result is to inject at a rate at which the patient feels comfortable warmth without excessive flushing or feeling ill-that is, dizziness, nausea, and headache, symptoms that are rare.
Prior to the injection, it is important for the patient to be instructed to give frequent feedback about any developing warm feeling early on, so that the injection may be slowed down, or even temporarily stopped, before excessive, uncomfortable flushing occurs. Likewise, feedback by the patient needs to be given when the warm feeling has mostly subsided so that the injection may be resumed at a reduced rate. Eventually, the infusion will find the "happy medium" rate of injection, which maintains the "comfortable warmth" (see above).
Also, prior to the first few MP injections, explain that a taste of B vitamins usually appears during the infusion, often early in the push.
The physician needs to consider one major option, which has become routine in many quarters-the possible addition of calcium gluconate, 10 percent injectable. Some of the major reasons for deciding to include calcium are:
- If the patient feels consistently unwell for any reason after the MP (weakness, fatigue, sleepiness, palpitations-all rare and mild, if present).
- If the patient has a history, or laboratory evidence, of calcium deficit.
- If the physician's clinical judgment dictates it for any reason.
The dose of calcium gluconate 10 percent injectable varies from 4 cc to 10 cc, depending on the clinician's judgment. The key is to maintain balance without diluting the magnesium's positive effects.
A final caveat is that one needs to keep in mind the third of the troika-potassium. Over a period of time, IV magnesium may deplete potassium; the danger is that one may be tempted to increase the dose of magnesium, only to aggravate the low potassium picture. Always keep in mind that a potassium deficit may prevent magnesium repletion and vice-versa.
It is also, of course, possible to create calcium deficit by the MP. However, potassium depletion, in my experience, is clinically more frequent and more symptom-provoking, and at times alarming. (If needed, give the potassium by mouth-not I.V. I.V. push potassium is fatal. I use Micro K Extentabs, 10 MEQ, one to two times a day if potassium levels are under 4.0.)
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of four research studies on their treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia and chronic fatigue syndrome From Fatigued to Fantastic! and his newer The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.